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KMID : 1035920180210040177
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Journal of Minimally Invasive Surgery
2018 Volume.21 No. 4 p.177 ~ p.179
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Laparoscopic Rectovaginal Septal Repair without Mesh for Anterior Rectocele
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Kwak Han-Deok
Ju Jae-Kyun
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Abstract
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A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.
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KEYWORD
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Laparoscopy, Rectocele, Posterior vaginal wall, Rectovaginal septum
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